05D2058090 CLIA NUMBER - VONS PHARMACY #2692

Laboratory Demographics

  • CLIA Code: 05D2058090
  • Facility Name: VONS PHARMACY #2692
  • Facility Address: 2938 TAPO CANYON RD
    SIMI VALLEY, CA
    ZIP 93063
  • Facility Phone: 805 426-6040
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIELA PASSARELLI
  • NPI Number: 1700815743
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2058090
LAB Type Pharmacy
Facility Name VONS PHARMACY #2692
Street 2938 TAPO CANYON RD
City SIMI VALLEY
State CA
ZIP 93063
Phone 805 426-6040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Pharmacy
Lab Director MARIELA PASSARELLI

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This page was last updated on: 9/29/2025